Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1114346442 Individual Practitioner Female Practitioner

Dr. Nicki Nabavizadeh , MD

Pediatrics • Gresham, OR

Professional Overview & Biography Verified Profile Summary

Dr. Nicki Nabavizadeh, MD is a registered healthcare professional specializing in Pediatrics in Gresham, OR. Practice services are available at 25050 SE STARK ST STE 300 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

25050 Se Stark St Ste 300

Gresham, OR 970303388

Telephone 5036678878

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Gresham, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.9 Yrs
Regional Practice Density
22 Specialists

Practicing in Gresham, OR (880 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-01-27
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License OR MD183100

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
NPI 1144970344

Doctor of Medicine (M.D.)

Brooke Lowry , PA-C

Physician Assistant - Medical

NPI 1235278482

Physician Assistant (Certified)

NPI 1255764379

Doctor of Medicine (M.D.)

NPI 1306047881

Doctor of Medicine (M.D.)

NPI 1336141720

Doctor of Medicine (M.D.)

Emily Burd , PNP

Nurse Practitioner - Pediatrics

NPI 1386136463

Pediatric Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 27, 2026

Pediatrics (License #MD183100 in OR)

📍
Updated Practice Location April 23, 2019

Registered at 25050 SE STARK ST STE 300, GRESHAM, OR 970303388 (Tel: 5036678878)

📍
Updated Business Mailing Address April 23, 2019

Registered at 25050 SE STARK ST STE 300, GRESHAM, OR 970303388 (Tel: 5036678878)

👤
Provider Name / Credentials Updated April 23, 2019

Recorded as NICKI NABAVIZADEH, MD

NPI Profile Active May 01, 2017

NPI status registered as active in NPPES database

📍
Updated Business Mailing Address May 01, 2017

Registered at 1510 DIVISION ST STE 280, OREGON CITY, OR 970452550

📍
Updated Practice Location May 01, 2017

Registered at 3181 SW SAM JACKSON PARK RD, PORTLAND, OR 972393011 (Tel: 5034948211)

👤
Provider Name / Credentials Updated May 01, 2017

Recorded as NICKI NABAVIZADEH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2017

Pediatrics (License #813100 in OR)

NPI Profile Active April 15, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location April 15, 2014

Registered at 3181 SW SAM JACKSON PARK RD, PORTLAND, OR 972393011 (Tel: 5034948211)

📍
Updated Business Mailing Address April 15, 2014

Registered at 3181 SW SAM JACKSON PARK RD, PORTLAND, OR 972393011

👤
Provider Name / Credentials Updated April 15, 2014

Recorded as NICKI NABAVIZADEH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 15, 2014

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 15, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114346442
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 15, 2014
Last Update: January 27, 2026
Sole Proprietor: No

Mailing Address

25050 Se Stark St Ste 300

Gresham, OR 970303388

Phone: 5036678878

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.